What? I am playing on very hard as well and doing my usual stupid shit of just going in a direction and trying to clear areas. Still I don't find the game very difficult, and I am killing shit with a skull next to its name a lot. The game gives you an instant pause in which you can heal, you can save at your leisure, and there is auto-aim and the ability to pick your crits. I die a lot, but all that should be enough to trudge through areas well above your level. I haven't used Power Armor a single time, and it feels like cheating if I would. Frequent saving just means that you have to play a difficult engagement a few times until you figure out the right strategy, which I find quite fun and rewarding. Just make sure you upgrade your guns, upgrade your armor and invest in some of those "+20% damage perk with X weapon type" perks and it should be easy enough. If it really gets hard, use your explosives, they are easy to use and usually quite effective. If it weren't for ammo constraints, my upgraded Laser Rifle would beast through anything, and I have had that one for a while. The real difficulty comes from trying to use .38 ammo against moderately strong enemies, because your other ammo is too precious.
Though that one time I reloaded about 11 times to kill a Legendary Bloatfly was quite embarrassing. It would one-shot me with its projectile vomit, so doing frantic sidesteps while spastically hip-firing at a small bug and hoping for the best was the right strategy.